and Practice Questions
Odds of conceiving - ✔✔Odds are against it...
o Although ejaculate commonly contains 200-400 million sperm, only a few hundred actually reach the
ovum
o Ovum can live maximum of 24 hours after ovulation without fertilization
o At least 99% of sperm die within 72 hours of ejaculation
Odds increase if...
o Intercourse takes place a few days before to shortly after ovulation (i.e., a few hours)
o During intercourse, couple uses male-above position and female remains lying down after ejaculation
Causes and treatment of infertility - ✔✔Causes include...
o Anatomical abnormalities - e.g., endometriosis, scarring from STIs
o Age - female fertility declines after 30; male fertility declines less
o Abnormalities in sperm count/motility (motion)
o Substance abuse - e.g., alcohol, marijuana, narcotics, tobacco
o Environmental toxins - e.g., radiation, auto exhaust
Treatment -
o Nonmedical - for low sperm counters, ejaculate no more often than every 48 hours, wear looser
shorts, avoid hot baths
o Medications - clomiphene increases rates of FSH and LH, and Pergonal increases FSH, stimulating
ovulation
o Surgery - for example...
- Removal of scar tissue in fallopian tubes
- Varicose veins in scrotum
o Gestational carrier (surrogate mother) - volunteer who undergoes artificial insemination or in vitro
fertilization
,o Artificial insemination - partner or donor semen inserted into vagina, cervix, or uterus
o In vitro fertilization (IVF) -
- Ovaries are hormonally stimulated to release multiple eggs, which are removed, fertilized by sperm in
a lab, then (ideally) two are introduced into uterus
Gestational carrier - ✔✔Surrogate mother; volunteer who undergoes artificial insemination or in vitro
fertilization
Artificial insemination - ✔✔Partner or donor semen inserted into vagina, cervix, or uterus
In vitro fertilization - ✔✔Ovaries are hormonally stimulated to release multiple eggs, which are
removed, fertilized by sperm in a lab, then (ideally) two are introduced into uterus; Success rates about
30%
Early signs of pregnancy - ✔✔o Missed or slight menstrual period
o Breast tingling/tenderness - can also be caused by impending menstruation
o Fatigue
o Nausea/vomiting - experienced by 80% of pregnant women
o Human chorionic gonadotropin (hCG)
Human chorionic gonadotropin (hCG) - ✔✔hormone produced by an embryo following implantation.
The hormone helps maintain the uteral lining during pregnancy. The presence of HCG is detected in
pregnancy tests.
Spontaneous abortion - ✔✔The spontaneous expulsion of the fetus from the uterus early in pregnancy,
before it can survive on its own.
Self-care in pregnancy - ✔✔-Diet—eat 300 more calories per day.
o Average-weight moms should gain 25-35 pounds (more with multiple births).
o To prevent spinal chord abnormalities, increase folic acid.
,-Sex—usually safe unless pregnancy is at risk for miscarriage or prematurity.
-Medications—check with physician/pharmacist to determine if are safe in pregnancy.
-Environmental hazards—avoid , long soaks in hot tubs, and x-rays.
Viability/quickening - ✔✔Viability: Age at which fetus can possibly survive outside womb - at about
week 24.
Quickening: movement can be felt at usually 20th week
Major features of first, second, and third trimesters for fetus and mother - ✔✔First trimester (week 3 to
about 13) - stages of development
o Blastocyst - ball of cells filled with fluid that begins to implant about 7 days after fertilization
o Embryonic stage -
- After implantation through 8th week
- Major organ systems begin to develop
o Fetal stage -
- 9th week to birth (average at 40 weeks)
- Has majority of its parts and looks human
Second trimester (week 14-27) -
o Fetal development - size increases (from 1 oz to 2 lbs) and organs mature; brain begins to regulate
body
- Appearance of lanugo - fine hair covering body
- Vernix caseosa - cheesy material protecting skin from amniotic environment
- "Quickening"- movement can be felt at usually 20th week
- Fetus reaches viability (age at which can possibly survive outside womb) at about week 24
o Maternal effects -
- Decreased nausea/vomiting, increased energy
, - More pronounced abdominal bulging ("showing")
- May experience swelling of feet, less often hands
- Forgetfulness, mood swings
Third trimester (week 28-40) -
o Fetal development -
- Fetus gains significant weight - from 2 lbs to average 6 lbs/10oz to 8 lbs at birth
- Considerable brain growth occurs
- In ninth month fetus drops, and (hopefully) becomes head-down in preparation for delivery
o Maternal changes -
- Return of fatigue due to fetal size/nighttime acrobatics
- Increased constipation/urinary frequency
- Nesting urge
- May begin or have more frequent Braxton-Hicks contractions - usually painless tightening of uterus
Importance of folic acid - ✔✔promotes adequate fetal growth and prevents macrocytic, megaloblastic
anemia
Braxton-Hicks contractions - ✔✔intermittent painless uterine contractions that occur with increasing
frequency as the pregnancy progresses
Prenatal provider choices - ✔✔o OB/GYN - specialist in female reproductive health and childbirth
o Family practitioner - focuses on general medicine, including pediatrics
o Certified nurse/midwife
- Registered nurse with graduate training/national certification
- Focuses usually on natural childbirth and holistic care
Ectopic pregnancy - ✔✔o Implantation outside of uterus
o Implants anywhere other than the middle of the uterus